Does it look like my implants are bottoming out? I had them done 4 years ago (Photo)

Question

I recently lost 90 pounds and my implants have dropped they were done 4 years ago and they hurt so bad. Does it look like they are bottoming out ?

Gianfranco Frojo, MD · Answer

You may have capsular contracture. I would recommend seeing an American Board of Plastic Surgery certified surgeon for a physical exam/evaluation.

Daniel Barrett, MD · Answer

Dear Enthusiastic348265,
bottoming out occurs when the implant falls below the current breast crease or inframammary line. It's more likely to happen with inframammary incisions, which is why I try not to use the inframammary approach to any breast surgery.
Bottoming out can also occur if an implant is too large for the breast pocket. That is why it is important to choose an implant size that's correct for your body. I perform numerous measurements in the office to determine optimal implant size for my patient's bodies.
If you are concerned, please check it with your plastic surgeon for reassurance and to further discuss your options and possibility of revision.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Leila Kasrai, MD, FRCSC · Answer

It looks like your breasts are compressed and rippling. In addition to the pain, these are signs that you may have capsular contracture. Please see your surgeon for an assessment. The capsular contracture will require surgical intervention and the implants will need to be replaced.

Eleonore Zetrenne, MD · Answer

Your skin is too thin to carry such large implants, allso you have capsular contracture. The best thing would be to downsize the implants and do a breast lift.

Connie Hiers, MD, FACS · Answer

Your photos are somewhat limited, but true bottoming out is not present. However, they may be too large and heavy for you now.

Camille Cash, MD · Answer

Congratulations on your impressive weight loss.  From the photos it appears that you may have capsular contracture in both breasts.  This is where the capsule can become thickened and tightens around the implant.  I encourage you to return to your surgeon for an evaluation.  I've included a video on capsular contracture that I hope you find helpful.

Mats Hagstrom, MD (license on probation) · Answer

It looks like you have capsular contractions on both of your breasts.
Your implants are also a bit excessive in regards to size.
Pain would be most consistent with capsular contractions.
I suggest you follow up with the surgeon who did your breast augmentation or consult with other plastic surgeons in your community to get an accurate assessment and a better understanding of treatment options.The treatment of capsular contraction is usually covered by medical insurance.
That could be an important aspect, and can potentially save patients a significant amount of money in regards to a facility and anesthesia fees.
Discuss discuss with your providers or other plastic surgeons in your community.
Best,
Mats Hagstrom, MD

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